Project Summary HIV/AIDS is the world's leading infectious killer. Despite substantial research, the worldwide burden of HIV remains high. In 2013, over 2 million persons were newly infected and more than 35 million people were living with HIV. New global HIV prevention efforts that are readily available and affordable are needed. A growing literature suggests that human papillomavirus (HPV) infection may increase risk of HIV. The seven longitudinal studies conducted among women and men consistently demonstrate increased risk of HIV with prior anogenital HPV infection. However, unlike other STIs, HPV can be effectively prevented with vaccination. Few low-middle income countries (LMIC), where the HIV burden is highest, are vaccinating girls, and none include males in national programs. Only three countries currently recommend gender neutral HPV vaccination. We need more studies evaluating the association between HPV and HIV and whether HPV infection at multiple anatomic sites (genitals, anal canal, and oral cavity) and associated anogenital lesions increase HIV risk. In order to fill this knowledge gap, we propose to assess whether HPV infection is associated with HIV seroconversion among men in The HPV infection in Men (HIM) Study, a multinational, prospective male HPV natural history study. We aim to (1) Complete HPV genotyping of genital, anal, oral specimens among 1473 men who contributed study visits beyond year 4 of follow-up (up to 7 years of follow-up); (2) Evaluate the association between HPV infection at three anatomic sites and risk of HIV; and (3) Examine whether the association between HPV infection and HIV seroconversion is modified by infection with other STIs. The proposed research is innovative; as it is the first to assess HIV risk following HPV infection at three anatomic sites. The research aims are feasible given the existing HPV and HIV data. Results from this study may help inform future HIV prevention research and policies.